THE EFFECTS OF A SYNTHETIC CURARE-LIKE COMPOUND, THE TRI-IODO SALT OF TRIS (TRIETHYLAMINOETHOXY) 1, 2, 3 BENZENE (FLAXEDIL), ON THE ANESTHETIZED SURGICAL PATIENT

¹ Departments of Surgery (Anesthesia) and Pharmacology, Cornell University Medical College and the New York Hospital, New York 21, New York

The curariform effects of the tri-iodo salt of tris (triethylaminoethoxy) 1, 2, 3 benzene (Flaxedil) were determined on 57 anesthetized surgical patients. To accomplish this, the respiratory minute volume (RMV) was recorded continuously as an indicator of respiratory muscle function. A dose of 0.5 mgm./kgm. given intravenously produced the minimal response; a dose of 2.0 mgm./kgm. produced a nearly complete neuromuscular paralysis in the average patient. The duration of the curariform effect of Flaxedil depended on the magnitude of the dose.

Despite observed recovery of the RMV, the repetition of the Flaxedil dose, within 40 minutes of the first dose, evidenced a cumulative action.

The curariform action of Flaxedil was not influenced by the anesthetic agents employed, namely, cyclopropane and ether. This contrasts with the well-known synergism between ether and d-tubocurarine.

Flaxedil increased the heart rate in each patient and the effect on heart rate heralded the onset of the drug action. This action is attributed to a specific blockade of the cardiac vagus.

The curariform and vagolytic actions of Flaxedil were antagonized quickly and effectively by the anti-curare agents, Ro 2-2561 and Ro 2-3198.

Flaxedil did not produce any significant effects on blood pressure or cardiac rhythm in the anesthetized surgical patient. No untoward effects attributable to the drug were observed.

An intravenous dose of 1.0 to 1.5 mgm./kgm. of Flaxedil is recommended as an adjuvant to surgery in man under the conditions of anesthesia described.